Compassion Clubs Advance Toward Authorization in Vancouver

    The headlines suggested that sanctioned heroin clubs were coming imminently to Vancouver, British Columbia. The truth is a little different. Nevertheless, harm reduction advocates will be following closely after the Vancouver City Council voted almost unanimously on October 7 to support a call for a “section 56 exemption” to the Controlled Drugs and Substances Act (CDSA): It effectively asks the government to legalize, evaluate and even fund compassion clubs and a fulfillment center offering a safe supply of heroin, methamphetamine and cocaine to adults at risk of overdose.

    The exemption, if granted by Health Canada, would allow the Drug Users Liberation Front (DULF) and Vancouver Area Network of Drug Users (VANDU) to run a 200-person, 15-month pilot project to purchase, test and distribute drugs. They would test the supply for potency and composition using Fourier-transform infrared spectroscopy (FTIR) drug-checking services, and fentanyl and benzodiazepine immunoassay test strips. 

    The groups have simultaneously requested CA $268,947 in funding for the project through a Substance Use and Addictions Program grant from Health Canada. It’s a funding stream specifically intended to support community-led projects to reduce harms associated with drug use, including through safe supply.

    “The illicit variant of our project, anyone could do,” Eris Nyx, one of DULF’s founding co-organizers, told Filter. “Can you please just give us a licit path to this?”

    Indeed, as I reported in Filter in 2019, drug users have for years operated similar clubs, including in British Columbia and Ontario, to collectively purchase and check the composition of drugs, obtained from sources including the “dark web.” Yet the advantages of being able to do this work without fear of arrest and with vastly increased resources would be obvious.

    “I’ve lost two-thirds of the people I know in the Downtown Eastside.”

    Equally obvious are the benefits of such clubs to members seeking to avoid the risks of adulterants widely present in the supply, including fentanyl.

    “I’ve had some very weird moments with fentanyl. When I see it, I see tombstones in my mind,” Hugh Lampkin, a long-time member of VANDU, told Filter. “I’ve lost two-thirds of the people I know in the Downtown Eastside.”

    Lampkin explained that trauma dating to his childhood led him to use heroin, while racism (“walking while Black”), along with criminalization of drug users, brought him years of unwanted interactions with police.

    “You spend most of your time hustling to get a paper or a point,” he said of his addiction. “If you could stabilize people and you could just go and get it, as long as they have [access to checked drugs], their lives will change. It’s always a positive thing you see.” 

    Lampkin describes himself as stabilized on a form of time-release morphine—and on the comradeship and empowerment he’s found through VANDU—after many years depending on the ever-more-dangerous illicit market. 

    “People try to, but they can never find a reliable source of heroin,” Jeremy Kalicum, DULF’s other founding organizer, told Filter.

    Since 2019, DULF, with VANDU members and other volunteers, has carried out a number of widely publicized events at which they handed out free, tested, DULF-branded and ingredient-labelled drugs (so far they have spent about CA $15,000 on drugs). 

    The recent exemption request asked for a government decision—or even an emergency, temporary decision—by October 15. But the recent federal elections mean that no one is surprised that the date came and went without a sign.

    In fact, there’s no required or expected timeline for Health Canada to respond to a section 56 exemption request (a number of such requests are pending or expected across the country right now, including requests for decriminalization from the City of Toronto to be submitted this fall, and one from the city of Vancouver that was submitted in May). 

    If the government ever responds, the exact details of the compassion club model will depend on what sort of stipulations Health Canada places on the proposal. 

    Kalicum is realistic about this; while he acknowledges that a known supply of prescription fentanyl for people who choose to use it would save lives, “I just don’t think the public’s ready for that.” The consensus decision was therefore to leave fentanyl out of the exemption request for strategic reasons, he explained. 

     

    Procuring Safe Drugs

    Another major detail relates to the source of the heroin, methamphetamine and cocaine to be used in the project.

    “I’m officially labeled as a ‘drug dealer’ by some,” Jean Swanson, the city councillor and long-time social justice activist who advanced the city council motion, told Filter.

    Back on July 14, Swanson openly joined DULF and VANDU in an action in the Downtown Eastside, the Vancouver neighborhood that has been hit hardest by overdose and where there is probably a greater concentration of harm reduction services than anywhere else in the world. At this action, volunteers handed out free, tested heroin, methamphetamine and cocaine to drug users who pre-registered for the event. No overdoses were reported following this or other DULF actions.

    “It was the easiest decision I’ve made since I got elected,” Swanson said, citing the need to overcome stigma against people who use drugs and the fact that both people with addictions and casual users are dying from an essentially poisoned drug market.

    In a significant, shift-signaling win, Vancouver city police formally declined to lay charges against the councillor in response to an anonymous complaint after the event.

    The police department wrote, “While the VPD does not condone drug trafficking and, in fact, does arrest for drug trafficking, it is recognized that the actions of the other protesters were not motivated by profit and were not the actions of organized crime groups, but rather, were grounded in harm reduction and raising awareness to the need for urgent action to the overdose crisis […] Given the totality of the circumstances as they relate to this event, including the need to maintain public peace during the protest, officers used their discretion and chose not to take enforcement action.”

    Research specific to Vancouver suggests that diversion provides respite from the risks inherent in the illicit market.

    A common concern raised about safe supply is that “diversion” may result. Although Nyx carefully designed DULF’s packaging to resemble cigarette packaging and not appeal to children, she points out that diversion of pharmaceutical-grade opioids and stimulants would prevent the overdoses she sees daily when she opens her front door in the Downtown Eastside. 

    Indeed, new research specific to Vancouver suggests that diversion provides respite from the risks inherent in the illicit market, while illicit fentanyl, not prescription opioids, continues to drive overdose deaths in the province of BC.

    The motion as written requires that city council support for compassion clubs is conditional on them procuring their drugs from “a legal regulated source that does not benefit organized crime.”

    This may be a challenge to achieve at scale—although Canada does, for example, have a very new, not-for-profit company dedicated to domestic prescription heroin production. DULF has yet to reach out to potential producers of pharmaceutical-grade cocaine or methamphetamine.

    In a precedent of sorts, federally permitted safe consumption sites across the country do, of course, permit the use of drugs from which people who sell illicitly have profited. But harm reductionists would argue that’s not the point, when these sites unequivocally save lives. 

     

    A National Stalemate

    The national situation around drug policy is a weird and dangerous stalemate. The Liberal government has persistently refused to consider decriminalization of all substances, although it did legalize cannabis for recreational use in 2018 and has repeatedly solicited drug users’ and other experts’ input on how to respond to overdose. In fact, at its 2018 convention, Liberal Party of Canada delegates passed a resolution in support of reclassifying low-level drug consumption and possession as administrative offenses, a form of decriminalization. 

    “There’s something sinister to the government’s behavior in this situation,” said Nyx, who intends—somehow—to run the compassion clubs project illegally if it is not funded and authorized by the feds. As Swanson noted, “Vancouver has a long history of having people do illegal things to get the government to make them legal, starting with supervised injection sites.”

    Compassion clubs are intended to take control over what people put in their bodies away from both the medical and policing professions—giving it back to the people who use these substances in a supportive environment.

    In this way, they aim to address failings of existing safe supply programs: an overly medicalized model, high barriers to participation and drugs that aren’t what people are actually seeking—which reduces their effectiveness as a safer replacement for illicit drugs.

    “That’s why we want it out of a medicalized system,” Kalicum said. “All these regulations, it doesn’t work for people. That’s kind of the reality of the situation.”

    Most of all, compassion clubs—whether or not they’re authorized and funded by the government, evaluated and scaled to the true level of need—offer empowerment because they’re a drug user-led response.

    “People can say what they want about drug users,” Lampkin said. “But the other part is we are saving each other’s lives. We have each other, and we’ve found people that listen to us.”

     


     

    Photograph via Drug User Liberation Front

    • Carlyn is a freelance journalist based in Toronto. She writes about pain, struggle, injustice, drugs, exile, suffering—and how to make it better. Her work has appeared in publications including the Washington Post, the Guardian and the Globe and Mail.

      Her second book, On Opium, was published in Canada in September. Her memoir, Opium Eater: The New Confessions, was a Globe and Mail Best 100 book of 2016.

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